Read Administrative Law updates, alerts, news, and legal analysis from leading lawyers and law firms:
Konczal: Dodd-Frank Reforms Get Roughed Up in Court
Medicaid Receiving Startlingly Little Attention As Everyone Discusses Medicare
Obama Administration Calls for Free Access to Federally Funded Research
Can Virginia Block Non-Residents from FOIA Requests? Supreme Court Hears Oral Arguments
Should Wall Street Fear Mary Jo White?
Looking Ahead to Washington State’s Legalized Marijuana Marketplace
Congressman: My Plan Would Reduce Student Loan Defaults: Video
Local Governments Continue to Fight States for Right to Govern Fracking
Tax Questions to Ask Yourself with the End of 2012 and the Fiscal Cliff Approaching
Obama Blocks Chinese-Owned Wind Project Out of Concerns for National Security
Crystal Ball Perspective: Will Healthcare Reform be Repealed if Romney Wins the Presidential Election?
Stewart Baker, Former GC of NSA, on Why the Cybersecurity Act Failed & Threat of Tomorrow’s Terrorism
Not Prepared for Healthcare Reform? Three things employers need to focus on now.
Who pays for road damage in Pennsylvania after ACT 13?
Smartphone Data Solution: Sharing Airwaves
The Apellate Process Explained - Kathi Sandweiss discusses the appeals process and what it can and can't do for your situation.
Marcellus gas fuels Natural Gas Vehicles
Natural gas encourages industrial and large commercial end-users to revisit their operational plans
NLRB Posting Rule Delayed Again, Will We Ever See Resolution?—McKenna Long's Seth Borden
Is there a way to safely use social media in the interview process?
Recovery Audit Contractors (“RACs”) and other Centers for Medicare and Medicaid Services (CMS) contractors are charged with identifying overpayments made by Medicare to healthcare providers. However, with the increase in RAC...more
On February 13, CGS Administrators, the Parts A and B Medicare Administrative Contractor for Kentucky and Ohio, relayed instructions to Medicare hospitals paid under the Inpatient Prospective Payment System from the Centers...more
Last week, the U.S. Department of Health and Human Services (HHS) and the DOJ jointly released a report concluding that, for every dollar spent on healthcare fraud investigations in the last three years, the government...more
Before a Medicare contractor can use extrapolation to determine an overpayment amount, the Medicare statute requires that it must make a finding that there is a sustained or high level of payment error or that documented...more
Under the Medicare statute and implementing regulation, providers have 180 days from the issuance of a Notice of Program Reimbursement (NPR) in which to file an appeal to the Provider Reimbursement Review Board (PRRB). This...more
On January 7, 2013, HHS OIG published a favorable advisory opinion on a management arrangement between a hospital and a cardiology group related to the provision of certain cardiac catheterization services at the hospital. ...more
Your employee handbook likely addresses, in great detail, the do's and don'ts of using the internet while at the office, guidance on HIPAA, and even the company's policy on sexual harassment, but does it provide any...more
In This Issue:
- Fiscal Cliff Deal Lengthens Medicare Overpayment Recovery Period
- Cutting Medicaid Provider Tax May Shift Costs to States, CRS Finds
- MedPAC Finalizes Payment Recommendations, GAO Solicits...more
On December 17, 2012, the Ministry of Health (“MOH”) issued the Tentative Guidelines for Centralized Procurement of High Value Medical Consumables (the “Guidelines”) with immediate effect, with an aim to control health care...more
The recently passed fiscal cliff legislation, i.e., the American Taxpayer Relief Act of 2012 (Act) [PDF], includes a number of provisions addressing Medicare and Medicaid. One of these provisions extends the recovery period...more
The ATRA significantly alters provider rights related to overpayment recoupment, refunds, audits and claims appeals. A provision entitled "Removing obstacles to collection of overpayments" increases the statute of limitations...more
Executive Summary: False Claims Act actions against government contractors are on the rise. But two recent decisions offer potential limitations to false claims exposure, and may aid defendants in future FCA litigation....more
CMS is seeking comments from hospitals, electronic health record (EHR) vendors, and other interested parties regarding whether hospitals could be ready as early as January 1, 2014, to electronically report patient-level...more
I always like to make predictions at the beginning of each year. My track record is plus and minus – sometimes on target, sometimes off-target.
The biggest story in the last five years has been the rise of FCPA...more
Healthcare suppliers and service providers live in a regulated world. They are constantly under audit scrutiny. Sometimes federal agencies (i.e private contractors) conduct the audits; other times state agencies conduct the...more
Texas Medicaid providers that receive referrals from non-participating physicians or other health care providers need to beaware that beginning January 1, 2013, individual providers who arenot currently enrolled in Texas...more
The Department of Justice (DOJ) has announced that Jacksonville, Florida-based American Sleep Medicine LLC has settled allegations that it fraudulently billed Medicare, TRICARE (the health care program for uniformed...more
In Advisory Opinion 12-21, the OIG concluded that a Federally qualified health center’s offer of grocery store gift cards to capitated managed care patients would not constitute grounds for the imposition of sanctions under...more
In a pending False Claims Act (“FCA”) case involving allegations of noncompliance with the federal physician self-referral law (the “Stark Law”), 42 U.S.C. § 1395nn, the United States District Court for the Middle District of...more
The federal government faces overwhelming challenges in trying to stem the tide of fraud in the health care system. The problem is massive, and even with the increase in resources, and adoption of new tools to fight fraud,...more
On December 31, 2012, Congress sent the Medicare IVIG Access and Strengthening Medicare and Repaying Taxpayers Act (“the Act”) of 2012 to President Barack Obama for signature. The Act had strong bipartisan support, passing in...more
From the perspective of False Claims Act (FCA) results, 2012 was a decidedly mixed year for healthcare providers. The bad news was quite bad—increased FCA scrutiny by the Department of Justice (DOJ) led to $3 billion of...more
When it comes to healthcare fraud enforcement, the government knows how to target its resources. It is estimated that at least 25 percent of all claims paid by Medicare are improper. The government understands the...more
Providers can voluntarily disclose potential fraud with respect to Federal health care programs — Medicare, Medicaid, and potentially private insurers to the extent Federal or state funds are involved — by following the...more
Although the Department of Health and Human Services (HHS) issued the final conflict of interest rule last year, many entities conducting research that is funded under Public Health Service (PHS) grants, cooperative...more
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